With the present health manpower shortage and the unequal distribution of health resources, there is need to demonstrate effective and economical means of providing more accessible health services. Our experiences in rural Mississippi and in our nurse-midwifery education program have shown in a limited fashion that a maternal-infant health care team with the nurse-midwife as the central figure is a highly effective means of delivering maternal and infant health care. The purpose of this prospective, longitudinal study is to demonstrate and evaluate the cost, utilization and effectiveness of health care provided to low-income patients by a MCH care team based at the University Medical Center and in outreach services in urban and rural communities. Comparisons of health outcomes, quality of management of care, delivery patterns and procedures will be demonstrated in: a. an experimental study at a teaching hospital b. an experimental study in MIC project c. a descriptive study of a midwifery service based in health department/private community hospital without house staff or obstetrician in a rural community d. a descriptive study of a midwifery service based in private health department/private community hospital without house staff in small urban community.